Breakthrough laser technology could change the way doctors treat epilepsy

Dr. Gerald Grant, Trinity ‘89 and associate professor of neurosurgery at Stanford University, returned to his alma mater Thursday for a talk on robotic surgery for epilepsy.

The lecture, which was hosted by Duke's FOCUS program, is part of the ReFOCUS series that provides former FOCUS students with the opportunity to continue to be involved with the program.

In his talk, Grant said that more than two million people in the United States suffer from epilepsy, and 400,000 to 600,000 people have seizures that cannot be controlled by antiepileptic drugs.

“The quality of life is the most important and unfortunately, with epilepsy, unless we make them seizure-free, the patients’ quality of life does not improve a whole lot,” Grant said.

Though 25 to 50 percent of patients with epilepsy can be potential candidates for surgical treatment, only 3,000 surgical procedures are performed annually in the United States because surgery is often viewed as experimental, a “last-ditch effort” or high risk, he said.

However, new development in the field of robotic surgery may change the situation.

“Robotics is going to play a role especially with those patients we used to say ‘sorry, we’re not sure’ to,” Grant said.

Grant explained that scientists have developed a method of using lasers to remove tumors that requires only a one millimeter opening. The doctors rely on MRI technology to provide information on the heat levels within the brain.

“Imagine a wedge,” said Grant. “We used to take out this huge area on top, but really, it’s all focused at the bottom.”

With this new laser technology, doctors no longer need to shave patients’ heads either, which can be an especially big deal for younger patients. Patients are also able to be discharged after only one day in the hospital, Grant explained.

Additionally, Grant praised the development of the NeuroPace, a device that is analogous to a pacemaker for the brain and is dependent on the RNS system, a brain stimulation treatment that monitors brain activity and wirelessly records information about seizure activity.

“For epilepsy, this technology is taking off,” he said.

Grant noted that a seven-year data collection project shows support for the long-term safety and effectiveness of the RNS system, with a 72 percent median seizure elimination rate. Patients, in response, have been much more willing to undergo operations with new laser technology in comparison to a traditional surgery.

“It is very unusual that changes these dramatic can happen by technology developments all at once, like robotics, laser technology and mapping the epileptic network,” Grant said. “This allows us to take patients where we couldn’t before.”